Written Testimony of Mehmet Oz, M.D. Vice-Chair and Professor of Surgery at Columbia University, Director of the Heart Institute

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Written Testimony of Mehmet Oz, M.D. Vice-Chair and Professor of Surgery at Columbia University, Director of the Heart Institute at New York Presbyterian and Founder/Chairman of HealthCorps

Before the Senate Health, Education, Labor and Pensions Committee February 26, 2009

I commend the committee for reaching out to find new ways of addressing the poor health record and staggering health care expenditures gripping our country, especially in light of the growing ranks of uninsured people caused by the economic turndown.

We spend roughly twice as much per capita on healthcare than our counterparts in Europe, but do not appear to derive value for this investment. Part of the reason is that Americans are twice as sick as Europeans as a people because of our chronic disease burden.1 Since lifestyle choices drive 70% of the aging process, most experts agree that we should focus on what we put in our mouths (food and addictions), how we tune our engines (exercise and sleep) and how we cope with stress (community and psychological growth). A key solution is support for a Smart Patient movement that integrates complementary and alternative medical (CAM) approaches to conventional medical treatment. We can combine the best of modern American medical practices with alternative approaches to wellness and harvest the natural healing powers of our bodies. CAM is not just about extreme treatments for advanced disease when no other solutions are available. It is about taking a population that has gotten comfortable living with half of the energy and sense of physical well being that they should have at their age and moving them up the spectrum to live at full vitality.

I saw this first hand when we traveled to the oldest populations on our planet for the Oprah Winfrey Show. Dan Beuttner helped us understand why the odds of living to age 100 with the vitality we desire was four times higher that than the U.S. in places without advanced health care technology like Okinawa, Costa Rica, and Sardinia. These people live with simple habits like daily arduous physical activity, eating whole foods, and relying on local healing practices that are minimalistic yet effective. We also found a similar cluster of centenarians in our own country, Loma Linda, California.

Complementary and Alternative Medical Practices

We can combine the best of modern American medical practices with alternative approaches to wellness and harvest the natural healing powers of our bodies. If successful, we can provide our population with the vitality that we crave. Please let me explain this vision by explaining how I got involved in the movement.

As Vice-Chair and Professor of Surgery at Columbia University and Director of the Heart Institute at New York Presbyterian, I’m in the operating room every week and have performed thousands of heart operations utilizing the most state-of-the-art equipment and innovative approaches of science in order to

1 Kenneth E. Thorpe, David H. Howard, Katya Galacionova, Differences in Disease Prevalence as a Source of the U.S.-European Health Care Spending Gap (Data Watch, October 2, 2007) 678-686.

save lives. I spent much of my life past the cutting edge as I operated on the bleeding edge of medicine. My specialty was mechanical heart pumps (See Appendix A – Visual of Mechanical Heart Pump) and transplantation and my patients were barely gripping the ledge of life as they pulled themselves up from the crevice of death. To survive, they needed a pump to replace their failing organ, but this was not enough. They also wanted to return to a fulfilling life, so they introduced me to their “other” healers- hypnotherapists, massage therapists, spiritual healers, and even energy medicine experts like Reiki masters. Clearly these patients had not read the same books that I got in medical school.

So we began offering massage and meditation, and even audiotapes in the operating room with some internal resistance, but general support from a medical community that recognized that conventional medicine alone could not offer the robust, holistic approach that our patients deserved. We started a center where we paid salaries of complementary and alternative medical (CAM) practitioners to offer free services to all of our heart surgery patients. We had two goals. First introduce patients to new powerful lifestyle approaches that they could do on their own after discharge. Second, evaluate rather than just advocate these unconventional approaches to see what works and spread the word by publishing in mainstream journals. We researched if we could reduce pain medications with hypnosis, if we could improve survival after heart procedures with prayer, and if we could alter memory with what patients hear during their operations. As we merged high tech to low tech approaches, folks around the hospital started to notice, and so did the media as evidenced by this early piece in the New York Times Magazine.2

My interest in incorporating these CAM techniques began to spread as I followed the literature and traveled overseas to perform heart surgery in China, visit medical facilities in Turkey and train in France. Foreign patients and practitioners had different expectations from their health care systems than Americans. In fact, I realized that CAM is really the globalization of medicine. My testimony today will be quickly available all over the world with other news from today. Financial services are clearly global, which is part of today’s economic turmoil story. But medicine has remained remarkably provincial. The globalization of medicine mandates that we incorporate foreign approaches like traditional Chinese and Ayurvedic healing practices into Western medicine.

Globalization of Integrative Health Treatments

In fact, people are crying out for the opportunity to play a greater role in their own well being. So we need to take the experience of a few and make it the norm for all. What we are really speaking about is morphing the current sophisticated health care system into one that is continually audited and improved by Smart Patients. What we have built are remarkable highways that carry people towards health. But to create a superhighway that is safe, we need better driver’s education. And we need Smart Patients to spread this approach throughout the system. We even wrote a YOU book with the Joint Commission, our nation’s health safety advocate, to serve as a metaphorical driver’s education pamphlet. (See Appendix B for reference to You:The Smart Patient.) The book hit the New York Times best-seller list, demonstrating the voracious appetite that our population has for information if presented in an accessible fashion.

So how do we provide a booster rocket for improving our population’s awareness of complementary and alternative medical (CAM) and lifestyle solutions? First, we need to incorporate CAM into the

2 Chip Brown, The Experiments of Dr. Oz (The New York Times Magazine) 21-23. conventional health care economy, including insurance company reimbursement when appropriate. This means we need simple means for credentialing all these practitioners and easier access to research money for unconventional therapies. CAM treatments often cannot afford major investments into proving their efficacy because the potential profits are limited. Ironically, the most cost effective therapies are the most difficult to research for the very reason that our government and other payers desire them.

HealthCorps®-A Peer Mentoring Model for a Healthier America

Second, let’s support the ServiceNation initiative that seeks to make volunteerism part of mainstream American life. Many of these volunteers could help spread health lifestyle information throughout our nation, as we have proven through the HealthCorps® www.healthcorps.org peer mentoring initiative in our nation’s high schools. I founded HealthCorps in 2003. (See Appendix C-HealthCorps Summary)

Here was our rationale. The major driver of chronic disease in this country is obesity and the increase in childhood obesity rates is twice as fast as the adult rate. I am seeing this first hand as we have started operating on obese 25 year-olds with artery blockages. I have been invited to Department of Health and Human Services panels to brainstorm solutions and contend that no single remedy will make America well. Instead, public/private partnerships will produce the most successful vehicles for educating and empowering children and families to make healthful decisions and assume responsibility for the most valuable asset they’ll ever inherit – their bodies.

The HealthCorps model is fashioned after the Peace Corps and can be duplicated in other areas like broadening the reach to our seniors of CAM and physical fitness approaches that are proven to reduce the burden of dementia, as well as offer improved function.

As you most likely know, children and teens like to make their own decisions and often reject the advice of parents and elders. HealthCorps Coordinators, who are the heart of the program, are typically recent college graduates who defer graduate studies to participate in public service. Our Coordinators represent a cross section of demographics, talent and achievement. Coordinators are assigned one school where they serve as a positive role model leading fun daily seminars on practical life skills associated with integrative health. They teach kids about nutrition and exercise and the tremendous power of positive thinking.

The mental resilience portion of the curriculum is arguably the most important – especially in light of the disturbing rise in teenage suicide in this country. The ten-fold increase in depression that we have seen in young people since the 1950’s is not a result of genes. It is most likely attributable to significant societal changes such as lessened sense of community, a lessened sense of social purpose greater than oneself, as well as a shrinking familial base of support. By empowering kids to take charge of their own bodies as well as effect change in their communities, we believe we can contribute to their sense of purpose, community and confidence.

Our Coordinators serve as a nexus for school-wide and community health events and activities, such as helping to script local health policy and working with other wellness non-profits to execute large-scale community health fairs. And the wonderful thing about service programs is that they not only influence those served, they influence the people serving, a new generation of doctors, health practitioners and future policy makers who disseminate a philosophy of integration.

Private/Public Partnerships

Instead of the expensive tests, procedures, medications and interventions that we now use to try to cure our nation, the methods HealthCorps proposes are attainable, affordable and sustainable with a long term substantial return on investment. The mechanism whereby we can institutionalize the concept of “HealthCorps” and take it quickly to all 50 states already exists at the federal level - AmeriCorps.

At a time when the job market is shrinking, young Americans have fewer choices after college. As an AmeriCorps program, HealthCorps could harness the power of thousands of amazing young people across the country to spread the message of integrative wellness and at the same time offer them a worthwhile job opportunity. HealthCorps can also partner with great federal programs such as the National Association of Community Health Centers (“NACHC”) to prospect for high school graduates interested in health careers who might devote a couple of years to service prior to considering college.

An AmeriCorps/HealthCorps partnership also represents investment in a broad nationwide movement. HealthCorps is strategically partnered with leading like-minded private and public initiatives such as The Tiger Woods Foundation, ServiceNation, the Center for Disease Control, the David Lynch Foundation, the International Health, Racquet and Sportsclub Association, Cleveland Clinic Initiatives, the Smart Choices Coalition, the Corporation for Public Broadcasting, the Human Neuroimaging Lab at Baylor College of Medicine, and the United Federation of Teachers (“UFT”), among others. HealthCorps also mobilizes a twenty-member Advisory Board (which includes experts in CAM, conventional medicine, business and non-profits) to participate in programming and community outreach.

I know that our public/private partnership is a good investment because science is substantiating our gains. In June, I will present the results of an independently conducted two-year efficacy study funded by Affinity Health Plan. Results of the study showed significant benefits of HealthCorps on decisions made by students.

Conclusion

We need to create systems that empower our citizens to get personally involved in improving the health of our nation. In fact, the most important contribution of CAM therapies is that frequently no one is giving you a pill or procedure or quick fix answer. There is no free lunch in health; instead you need to act for yourself to gain the vitality you desire. Our leaders need to deliver this honest message which is why I support the WIN proposal outlined by Dr Jonas that would create a White House office focused on lifestyle-based chronic disease prevention. And please remember that we cannot have a wealthy nation if we are not a healthy nation. Thank you for your valuable time, Mr. Chairman and Committee Members.

Attachments: Appendices A, B, C

APPENDIX A: VISUAL OF MECHANICAL HEART PUMP

APPENDIX B: YOU: THE SMART PATIENT

APPENDIX C: HEALTHCORPS SUMMARY

Program Summary

HealthCorps Responds to the Need

HealthCorps® is a proactive health movement that responds to the obesity crisis through school-based health education and peer mentoring, in addition to community outreach to underserved populations—mostly Hispanic and African American as well as groups with lower than average educational levels. HealthCorps (www.healthcorps.org) was founded in 2003 by cardiac surgeon, Dr. Mehmet Oz.

Along with educating students in healthy lifestyle principles, we extend our mission to their families and communities. Unlike the expensive tests, procedures, medications and interventions that we now use to cure our nation, the methods we propose are attainable and much more affordable. Our goal is to shift the paradigm towards health and wellness now and for the future of our children.

Problem Statement

Obesity in the United States has reached epidemic proportions, with more than 35% of Americans classified as obese and an additional 30% as overweight. Obesity has been a steadily rising trend since the late 1970s. Experts now predict that, without an intervention, the majority of the country will be obese by 2012. Alarmingly, the steepest increase is in children and adolescents. Obesity is directly linked to high blood pressure, type 2 diabetes and atherosclerosis. In turn, these unhealthy conditions are the major cause of heart attacks, strokes and heart failure. We are now seeing cardiovascular disease in teenagers and the average age of first heart attacks has dropped by over 10 years in the overweight patient. Other morbid conditions linked to obesity are certain cancers and arthritis.

There are many regional, ethnic, and economic divergences across the population of obese and overweight people in the U.S. Hispanics are the most overweight, although obesity is the highest among African Americans.

Program Summary

% Prevalence of Overweight and Obesity US (1999-2002) OVERWEIGHT OBESITY

White 36.8 24.2

Black 35.1 36.7 Hispanic 37.7 25.5 Other 31.9 18.7 Multi Racial 34.3 27 (Sources: Credit Suisse Demographics Research, 2008 CDC)

The American healthcare system is in crisis; unless we reverse the obesity epidemic, it threatens to exhaust the system’s manpower and economic resources in caring for those suffering from diseases associated with obesity. To avoid these mostly preventable diseases, our nation’s medical emphasis must shift from illness to wellness. Healthcorps is a catalyst for that change.

The HealthCorps Program HealthCorps is a national service program with tax-exempt status under Section 501(c)(3) of the Internal Revenue Code. The groundbreaking educational program currently runs in 44 high schools in seven states (CA, FL, NJ, NY, OH, PA, TX). HealthCorps’ strategic plan calls for implementation in 1,000 high school schools in all fifty states by 2012. The program impacts approximately 500 high school students per school per year.

The HealthCorps in-school program shows teens practical life skills through fun, interactive seminars focused on the value and power of students’ bodies and minds. Teens become educated consumers and health activists and are encouraged to develop positive behavioral shifts that enhance self-esteem. HealthCorps is based on a peer-mentor model, which has been shown to improve in a range of areas the outcomes of littles, including their academic performance, attitudes, and behaviors. HealthCorps Coordinators are typically recent college graduates who defer medical school or graduate health program studies to participate in public service.

Each Coordinator is assigned one school in which he or she lead seminars five days a week on fitness, nutrition and mental resilience. The seminars are taught through health or other academic classes or through after school clubs, as designated by the school principal. Seminar content is included in a 250-page curriculum and program guide developed by the HealthCorps Advisory Board.

Program Summary

In addition, we plan to introduce initiatives—through associations with the Tiger Woods Foundation and the David Lynch Foundation—to enhance the mental resilience portion of the curriculum in each HealthCorps high school.

HealthCorps’ delivers its in-class curriculum to approximately 500 students annually in each school. The students share some of the messaging with their friends and parents—thus increasing the reach to 1,500 people per school. In 2009, we hope to launch an online distance learning program, which will most likely increase reach to an additional 1,000 people per school annually.

HealthCorps extends its message beyond the four walls of the classroom in unique and far- reaching ways. First, each semester, the Coordinators host a community health fair—with typically about 2000-3000 attendees. Second, through a program with Siruis XM Radio, HealthCorps Board Chairman Dr. Mehmet Oz periodically features lessons from the HealthCorps curriculum with his radio audience. In the coming year, Dr. Oz will continue to promote the HealthCorps curriculum to parents of students via the daily syndicated Dr. Oz Show, which launches in September 2009. These radio and television broadcasts will reach millions of American homes.

In addition to driving HealthCorps student and community outreach, HealthCorps sponsorship represents an investment in a broad nationwide movement. HealthCorps is strategically partnered with leading private and public initiatives such as The Tiger Woods Foundation, ServiceNation, the Center for Disease Control’s Alliance to make U.S. Healthiest Nation, the David Lynch Foundation, the International Health, Racquet and Sportsclub Association, Cleveland Clinic Initiatives, the food industry’s Smart Choices Coalition, National Association of Community Health Centers, Channel 13 and the United Federation of Teachers (UFT), among others.

Organizational Capacity

The heart of HealthCorps is the Coordinator. As noted above, Coordinators are recent college graduates who have deferred medical school or graduate programs in health. At their assigned high school, they are full-time, salaried advocates for healthy lifestyles. Coordinators work with teachers before, during and after school to lead interactive workshops based on the HealthCorps curriculum. In addition, they serve as positive role models—mentors who help students form healthy attitudes, lifestyles and action plans.

Program Summary

HealthCorps Coordinators, graduates of some of the most respected universities in the United States, represent a diverse cross section of talent and achievement. HealthCorps follows strict hiring guidelines for Coordinators and requires that all

Coordinators undergo requisite school system background and fingerprinting checks prior to assignment. Many Coordinators will emerge as future leaders in medicine and public health policy.

For the 44 available Coordinator positions this year, HealthCorps received over 300 applications. We believe that we will have no difficulty recruiting and selecting Coordinators to facilitate our expansion. The executive staff of HealthCorps consists of ten full-time salaried employees based in New York City. The home office is responsible for the ongoing enhancement and evolution of the HealthCorps curriculum, Coordinator recruitment, relationships with and outreach to schools, community events and finance, marketing, and fundraising. The HealthCorps executive staff brings a wealth of public/private partnership, managerial, financial as well as educational experience to the organization. As we grow, we anticipate adding a few positions—primarily in finance, Coordinator recruitment and training.

A seven-member Board of Directors governs the organization. Members of the Board have expertise in finance, medicine, law, and entertainment.

A twenty-member Advisory Board, which includes experts in health, medicine, business and non-profits, participates in the ongoing enrichment of the programming and community outreach. We recruit these dedicated professionals from the entertainment, marketing, consumer products, human resources, finance and education communities. A list of board members is available at http://www.healthcorps.net/boardofdirectors.jsp http://www.healthcorps.net/boardofadvisors.jsp

HealthCorps’ founder and Chairman, Dr. Mehmet Oz, is one of the world’s leading cardiac surgeons as well as a best-selling author, and Health Expert on The Oprah Winfrey Show http://www.healthcorps.net/droz.jsp. He presides over the Board of Directors and guides the organization and its program.

At least 40 Celebrity Ambassadors—actors, musicians, athletes, authors—also volunteer their time to raise funds, generate media attention and build awareness for HealthCorps at community and fundraising events.

Program Summary

Efficacy

In June, Dr. Oz will present the results of an independently conducted two-year efficacy study overseen by a methodologist from Cornell University and funded by Affinity Health Plan. The focus of the study was to quantify the impact of the HealthCorps program on a predominately Hispanic New York City intervention group. Results of the study found significant benefits of HealthCorps on three dimensions: 1) soda pop consumption decreases by 0.61 times per week; 2) participants are 36% more likely to report that they are more physically active; 3) participants score 10.7% higher on the test of health knowledge. (These estimates assume zero benefit for dropouts; excluding dropouts results in larger effect sizes.) The Palm Healthcare Foundation, the leading healthcare foundation in Palm Beach County, Florida, is currently conducting an efficacy study in five Florida intervention schools. Results from this study are expected in 2010.

The Baylor School of Medicine, Human Neuroimaging Lab is funding and launching a six- month groundbreaking brain imaging efficacy study of the HealthCorps program in January 2009. Results from this study will be available by July 2009. HealthCorps will be seeking $1,500,000 in funding for the continuation of this study (to be overseen by Baylor through MRI lab strategic partners) over the course of the next four years in all HealthCorps states.

Budget

HealthCorps’ total operating budget for FY2009 is $4.5 million. The New York City Council, through the Department of Health and Mental Hygiene, is funding $1,500,000 of HealthCorps programming in the current fiscal year (July 1 through June 30). In FY 2009, The New Jersey Department of Health and Mental Hygiene is funding $225,000 of HealthCorps programming and New York State will be contributing $25,000. HealthCorps currently receives no Federal funding. Total funding is garnered through a combination of state, city, private foundations, corporate and individual contributions.

Each HealthCorps school program costs approximately $75,000.

HealthCorps projects it will be in 65 high schools in twelve states, including the District of Columbia (AZ, CA, DC, FL, GA, MS, NJ, NY, OH, PA, TN, TX) by fall 2009 (our FY 2010).

Contact: Michelle Bouchard, President, HealthCorps [email protected] O: 212.742.2875 C: 646.348.4175